Background Traditional estimates of SCD incidence in US high school athletes 1 athlete death per 200 000–400 000 athlete-years.
Objective To investigate the rate of SCA/SCD in high school athletes through search of media reports.
Design Retrospective review of the Parent Heart Watch database generated from systematic search of media reports. Each case was reviewed to confirm high school athletic team participation, sex, sport, and if the arrest occurred during exertion and at a school-sponsored activity. Sport participation numbers were available from the National Federation of State High School Associations.
Setting United States.
Participants 19 433 431 high school athletes (age 14-18) in 6 US states from 2007–2013.
Main outcome measurements Incidence of SCA/SCD.
Results The 6 states studied represented 36% of the high school athlete population in the US. During the study period, there were 109 overall SCAs, including 74 SCDs and 35 SCAs who survived. 91% of the SCAs occurred in male athletes. The overall SCA incidence in high school athletes was 1 in 63 988 athlete-years. The rate of SCA in males was 1 in 41 662 and in females 1 in 285 012 athlete-years. 83% of cases occurred during exertion and only 59% of events occurred while participating on a school sponsored team. 34 events occurred in male basketball players. The rate of SCA in male basketball players was 1 in 33 815 athlete-years.
Conclusions SCA/SCD rates in US high school athletes are significantly greater than previously reported, and disproportionately high in male basketball players, similar to collegiate athletes. These numbers represent low estimates as media reports have been shown to miss nearly 50% of cases. Accurate reporting mechanisms are needed in the US to define incidence and etiology of SCA. Current screening strategies in US high school athletes do not prevent SCA in many athletes, and alternative screening strategies should be considered, especially in high risk groups.
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